| NPI | 1215934302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27TO00029000) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 270A00463000) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2011-09-06 |