| NPI | 1447930581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5730) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: NJ 27OA00721800) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2024-08-15 |