| NPI | 1003595422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00731000) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG004049) |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2025-03-07 |