| NPI | 1811348972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003688) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00666700) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2021-10-19 |