| NPI | 1922648971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 009093) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003628) |
| 152W00000X Optometrist (Licence: NJ 27OA00704200) | |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2021-05-08 |