| NPI | 1811000367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00610100) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV-007038) |
| 152W00000X Optometrist (Licence: PA oeg003361) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2021-11-01 |