| NPI | 1366995524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00666500) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV008408-1) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |