| NPI | 1417251331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002011) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00628000) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2011-01-06 |