| NPI | 1679115935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003946) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9909TG) |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2024-04-24 |