| NPI | 1679762942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG002047) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY T007231) |
| 152W00000X Optometrist (Licence: NJ 27OA00612400) | |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2020-06-04 |