| NPI | 1396256780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003351) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OFC84) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2017-10-12 |