| NPI | 1376876227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2508) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002286) |
| 152W00000X Optometrist (Licence: CA 14589) | |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2018-07-20 |