| NPI | 1598315640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003737) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00690600) |
| 156F00000X Technician/Technologist (Licence: NJ 27OM00158200) | |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2021-09-29 |