| NPI | 1255323598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001586) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00597600) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2020-10-09 |