| NPI | 1518195353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 4875) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00621000) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2023-10-30 |