| NPI | 1003988296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001865) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001621) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2013-08-13 |