| NPI | 1336466481 |
|---|---|
| Former Name | JENNIFER MARIE KOTERWAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 287460-1) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA09828700) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2017-04-03 |