| NPI | 1861550592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA0842) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: MD TA0842) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2012-03-27 |