| NPI | 1124251657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5454) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002200) |
| 152W00000X Optometrist (Licence: NJ 27OA00621400) | |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2021-06-29 |