| NPI | 1407514631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3.003289) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003863) |
| Enumeration Date | 2021-12-05 |
| Last Update Date | 2023-07-07 |