| NPI | 1679658009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27TO 00139800) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ OA 00601200) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2007-07-08 |