| NPI | 1124011200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00679900) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006690) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2019-10-02 |