| NPI | 1083096218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003066) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002424) |
| 152W00000X Optometrist (Licence: MD TA2479) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2016-08-08 |