| NPI | 1265004402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5924) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00706300) |
| 152W00000X Optometrist (Licence: NJ 27OM00173600) | |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2024-05-06 |