| NPI | 1851395461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001473) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA1781) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2016-03-24 |