| NPI | 1285231597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00700800) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003984) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2023-05-10 |