| NPI | 1972889343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002092) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2284) |
| 152W00000X Optometrist (Licence: WV 1094OD) | |
| 152W00000X Optometrist (Licence: OH OPT.007243) | |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2026-03-04 |