| NPI | 1073865317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SD 749) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003108) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2023-04-04 |