| NPI | 1124156526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001874) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MS 803) |
| 152W00000X Optometrist (Licence: TN 2689) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-03-02 |