| NPI | 1891073839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618000481) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD DA 2260) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2011-07-25 |