| NPI | 1376151043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT002536) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003679) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2023-02-02 |