| NPI | 1912310673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP1000368) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2609) |
| 152W00000X Optometrist (Licence: VA 0618002604) | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2022-01-05 |