| NPI | 1710337043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003261) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 5224) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2018-03-17 |