| NPI | 1912429622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP1000366) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2710) |
| 152W00000X Optometrist (Licence: VA 0618002600) | |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2022-03-25 |