| NPI | 1083688501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA oeg001610) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL opc4057) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2025-09-27 |