| NPI | 1841389970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001582) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2012) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2008-04-15 |