| NPI | 1174637128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 706-OD) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG001174) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2016-11-14 |