| NPI | 1902635527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618003403) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA3037) |
| Enumeration Date | 2024-07-31 |
| Last Update Date | 2024-08-28 |