| NPI | 1326163122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003967) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 2861-035) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2023-01-05 |