| NPI | 1750674958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4857) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002340) |
| 152W00000X Optometrist (Licence: NH 0854) | |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2013-05-14 |