| NPI | 1164855029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4801) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002622) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2021-11-07 |