| NPI | 1043403355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00611700) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG001904) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2013-04-28 |