| NPI | 1619798543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NJ 27OA00732600) |
| Additional Taxonomies | 125Q00000X Oral Medicine (Licence: NJ 27OM00200100) |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2024-10-23 |