| NPI | 1891120309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA MN7341782) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008027) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2022-07-25 |