| NPI | 1932735412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 3007-IOD) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2754) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2022-09-28 |