| NPI | 1225316821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT14601TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00633500) |
| 152W00000X Optometrist (Licence: NJ 27OM00101000) | |
| 152W00000X Optometrist (Licence: NH 875) | |
| Enumeration Date | 2011-07-30 |
| Last Update Date | 2020-07-31 |