| NPI | 1215915590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 264) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA 0ET009051) |
| 152W00000X Optometrist (Licence: PA OE007953P) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2023-09-15 |