| NPI | 1831504976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002626) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5321) |
| 152W00000X Optometrist (Licence: IL 046.010812) | |
| 152W00000X Optometrist (Licence: MD TA2621) | |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2021-06-02 |