| NPI | 1649674094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 008233) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00663200) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2021-03-10 |