| NPI | 1245301191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OET008945) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003613) |
| 152W00000X Optometrist (Licence: NJ 27TO00067900) | |
| 152W00000X Optometrist (Licence: NJ 27OA00534600) | |
| 152W00000X Optometrist (Licence: VA 0618003167) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2024-12-18 |