| NPI | 1245550961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG002349) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007589-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2019-06-10 |