| NPI | 1205998234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27 OA00511200) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 005115) |
| 152W00000X Optometrist (Licence: WI 21335-875) | |
| 152W00000X Optometrist (Licence: OH OPT.007117) | |
| 152W00000X Optometrist (Licence: FL TPOP94) | |
| 152W00000X Optometrist (Licence: MN 3854) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2024-01-09 |