| NPI | 1770713471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2188) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA oeg002252) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2013-02-18 |