| NPI | 1194204578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00683500) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008860) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2019-12-06 |