| NPI | 1417339359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 4383AT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003059) |
| Enumeration Date | 2015-06-28 |
| Last Update Date | 2018-08-17 |