| NPI | 1447924329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003885) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009356) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2022-07-13 |