NPI | 1922406933 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: CO 3104) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG004001) |
152W00000X Optometrist (Licence: MD TA3031) | |
Enumeration Date | 2014-12-08 |
Last Update Date | 2024-09-03 |