| NPI | 1477845469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA1261) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OET009112) |
| 152W00000X Optometrist (Licence: PA OEG002718) | |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2013-08-30 |