| NPI | 1063584738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00604900) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007253) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-04-29 |