| NPI | 1700174497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003223) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2253) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2021-03-18 |