| NPI | 1225565997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003493) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5396) |
| 152W00000X Optometrist (Licence: NJ 27OA00686200) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2022-09-20 |