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 |