| NPI | 1871142604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00691500) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003598) |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2019-09-04 |