| NPI | 1568024016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00689200) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008994) |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2019-07-07 |