| NPI | 1003811183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001543) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: DE I3-0001413) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2019-11-07 |