| NPI | 1083832638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003698) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 006311) |
| 152W00000X Optometrist (Licence: GA OPT002321) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2024-04-11 |