| NPI | 1710575469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00702500) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV009276-01) |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2021-01-18 |