| NPI | 1003966839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001871) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL TPOP130) |
| 152W00000X Optometrist (Licence: MN 3839) | |
| 152W00000X Optometrist (Licence: WI 3844-35) | |
| 152W00000X Optometrist (Licence: VA 0618003191) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2023-03-06 |