| NPI | 1639484058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG002406) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00627500) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2019-06-04 |