| NPI | 1972847739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002216) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: DC OP1000279) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2015-08-17 |