| NPI | 1720677396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10171TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003748) |
| 152W00000X Optometrist (Licence: MD TA2778) | |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2022-01-12 |