| NPI | 1962579912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001324) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00569200) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2014-02-26 |