| NPI | 1902821382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA 0E006881T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 04955) |
| 152W00000X Optometrist (Licence: NJ T0325) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2013-07-30 |