| NPI | 1790152379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: PA OEG003074) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003074) |
| Enumeration Date | 2015-08-30 |
| Last Update Date | 2016-07-12 |