| NPI | 1508120957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00640200) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002714) |
| 152W00000X Optometrist (Licence: NJ 27OM00107400) | |
| Enumeration Date | 2012-06-30 |
| Last Update Date | 2021-04-12 |