| NPI | 1407318280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD DA2791) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00686300) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2021-07-06 |