| NPI | 1831202191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00595400) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG001456) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-07-08 |