| NPI | 1083066005 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: NH 0944) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003206) | 
| Enumeration Date | 2016-07-02 | 
| Last Update Date | 2020-05-11 |