| NPI | 1568592665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 12817345-9934) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA oeg001132) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2022-12-22 |