| NPI | 1104206465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003138) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002412) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2024-10-29 |