| NPI | 1588615926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE 130001296) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG001587) |
| 152W00000X Optometrist (Licence: NJ 27TO00128300) | |
| 152W00000X Optometrist (Licence: NY TUV0065431) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2012-03-19 |