| NPI | 1871071969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003712) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008856) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2021-06-19 |