| NPI | 1194796516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001731) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ OA00598800) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2010-06-30 |