| NPI | 1396052163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE I3-0001348) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002416) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2011-03-18 |