| NPI | 1588659437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00368600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ TPA 27TO00029600) |
| 152W00000X Optometrist (Licence: NJ 27OM00047500) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2009-09-29 |