| NPI | 1962014225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-002510) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003716) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2021-08-17 |