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 |