| NPI | 1659620516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2366) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002678) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2024-11-19 |