| NPI | 1053640540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE 130001334) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002293) |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2022-06-10 |