| NPI | 1629278049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2603) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG001914) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-05-26 |