| NPI | 1003320136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00685000) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV008709) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2020-11-12 |