| NPI | 1730636234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003220) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00668000) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2023-07-19 |