| NPI | 1942867981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2749) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003726) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2020-09-02 |