| NPI | 1811369044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002728) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 2963) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2019-02-26 |