| NPI | 1669949764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 3531) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003472) |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2019-08-08 |