| NPI | 1912430745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003966) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 3036) |
| Enumeration Date | 2017-04-08 |
| Last Update Date | 2023-02-23 |