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 |