| NPI | 1285910786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2255) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002471) |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2014-05-20 |