| NPI | 1568657047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001671) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG001907) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2023-03-11 |