| NPI | 1083700249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: NJ 27OM00084800) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 270A00588400) |
| 152WP0200X Optometrist Pediatrics (Licence: NJ 27OA00588400) | |
| 152WV0400X Optometrist Vision Therapy (Licence: NJ 27OA00588400) | |
| 152WX0102X Optometrist Occupational Vision (Licence: NJ 27OA00588400) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2015-02-10 |