| NPI | 1619498706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003437) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2583) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2018-10-10 |