| NPI | 1821218835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1744) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD MD1269) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2021-05-15 |