| NPI | 1952856700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2574) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2495) |
| 152W00000X Optometrist (Licence: VA 0618002517) | |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2022-01-24 |