| NPI | 1730563057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003093) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2512) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2018-01-30 |