| NPI | 1376847590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00628900) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00096000) |
| 152W00000X Optometrist (Licence: PA OEG002430) | |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2012-09-25 |