| NPI | 1316191018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003275) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007370) |
| 152W00000X Optometrist (Licence: DE I3-0001395) | |
| 152W00000X Optometrist (Licence: TX 7795-TG) | |
| 152W00000X Optometrist (Licence: WI 21329-875) | |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2022-09-15 |