| NPI | 1205211224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003378) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 5113) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2022-07-21 |