| NPI | 1700433505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE I3-0011429) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003597) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2021-03-10 |