| NPI | 1841453495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE 13-0001335) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002080) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2015-06-08 |