NPI | 1083835177 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00560200) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OM00044500) |
152W00000X Optometrist (Licence: NY TUV005975) | |
Enumeration Date | 2007-05-02 |
Last Update Date | 2016-02-05 |