| NPI | 1720210297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4630) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00623900) |
| 152W00000X Optometrist (Licence: PR 663) | |
| 152W00000X Optometrist (Licence: PA OEG002184) | |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2018-11-14 |