| NPI | 1114375805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002467) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003125) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2019-04-19 |