| NPI | 1740548627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG002699) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PR 689) |
| 152W00000X Optometrist (Licence: NJ 27OA00644000) | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2017-04-20 |