| NPI | 1710135454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: PA OEG002072) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: NY TUV007305) |
| Enumeration Date | 2008-09-06 |
| Last Update Date | 2016-03-02 |