| NPI | 1003129495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OM00131700) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00663300) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2015-10-20 |