| NPI | 1376062729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 3487) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003347) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2020-11-10 |