| NPI | 1114124385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG002171) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001668) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-11-04 |