| NPI | 1417484056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003286) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5340) |
| Enumeration Date | 2017-05-14 |
| Last Update Date | 2020-06-01 |