| NPI | 1023639275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003660) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003255) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2021-09-07 |