| NPI | 1144328212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4346) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG001373) |
| 152W00000X Optometrist (Licence: CA 14127) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-02-04 |