| NPI | 1376890459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: NJ #TD3650) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Licence: NJ #TD3650) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2012-08-08 |