| NPI | 1104366053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003227) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: DE I3-0001391) |
| Enumeration Date | 2017-02-26 |
| Last Update Date | 2018-08-13 |