NPI | 1255384152 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00603000) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007016-1) |
Enumeration Date | 2006-05-19 |
Last Update Date | 2011-04-04 |