| NPI | 1043682297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00662600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV008295-1) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2016-12-22 |