NPI | 1336215870 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG002191) |
Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC2466) |
152W00000X Optometrist (Licence: CA OPT 9110) | |
Enumeration Date | 2006-11-27 |
Last Update Date | 2016-06-10 |