| NPI | 1538541073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003071) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OFC73) |
| Enumeration Date | 2015-06-21 |
| Last Update Date | 2015-12-08 |