| NPI | 1710945589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 270A00602800) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006818) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2014-12-11 |