| NPI | 1124382601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2371) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002639) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2014-09-22 |