| NPI | 1811944085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG000493) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: PA OEG000493) |
| 152WL0500X Optometrist Low Vision Rehabilitation (Licence: PA OEG000493) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2008-10-10 |