| NPI | 1518198027 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 5005)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002249)  | 
| 152W00000X Optometrist (Licence: DE I3-0001336)  | |
| 152W00000X Optometrist (Licence: CO OPT0002867)  | |
| Enumeration Date | 2009-07-31 | 
| Last Update Date | 2022-07-21 |