| NPI | 1770685372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2149) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG01718) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2020-01-27 |