| NPI | 1366458580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL R157TA743) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00458000) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-03-24 |