| NPI | 1053973263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003576) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OB009474) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2020-10-06 |