| NPI | 1730103946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001588) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00519300) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2011-09-23 |