| NPI | 1558744409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5166) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003049) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2016-12-15 |