| NPI | 1831501303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG002901) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8449TG) |
| 152W00000X Optometrist (Licence: FL OPC5386) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2022-03-31 |