| NPI | 1114039302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00592600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 006888) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-12-05 |