| NPI | 1467659235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27oa00610600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007146) |
| 152W00000X Optometrist (Licence: NJ 27OM00036700) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2010-01-13 |