| NPI | 1356379010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 270A00513600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27T000036800) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2007-07-08 |