| NPI | 1053046771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: PA OEG004024) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: NJ 27OA00715000) |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2023-08-04 |