| NPI | 1104233436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.010910) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002979) |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2018-03-21 |