| NPI | 1972155901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY RT009241-01) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003578) |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2023-12-11 |