| NPI | 1669683496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OE008220T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 5568) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2013-03-04 |