| NPI | 1104981489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA005657) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001700) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2023-03-20 |