| NPI | 1679693741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00851100) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002681) |
| 183700000X Pharmacy Technician (Licence: MA 5793) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2022-07-21 |