| NPI | 1760682850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001943) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL FL4235) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2008-05-20 |