| NPI | 1306490750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 270A00723300) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002790) |
| 152W00000X Optometrist (Licence: FL OPFC92) | |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2024-02-23 |