| NPI | 1609490432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003681) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OM00167900) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2020-11-03 |