| NPI | 1194347849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG004200) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5476) |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2025-04-16 |