| NPI | 1659388114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OET008991) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL TPOP64) |
| 152W00000X Optometrist (Licence: WI 3861-35) | |
| 152W00000X Optometrist (Licence: MN 3690) | |
| 152W00000X Optometrist (Licence: NY 009081) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-03-06 |