| NPI | 1013998939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ OA00547300) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ TO00085100) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2011-03-22 |