| NPI | 1336300235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4699) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002055) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2019-03-20 |