| NPI | 1215299805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00638800) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2908) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2021-04-27 |