| NPI | 1659723930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2719) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003185) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2024-08-28 |