| NPI | 1417686627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2983) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003888) |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2024-05-24 |