| NPI | 1720561855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist Pediatrics (Licence: NJ 27OA00681200) |
| Additional Taxonomies | 152WP0200X Optometrist Pediatrics (Licence: CA 34392TLG) |
| 152WS0006X Optometrist Sports Vision (Licence: NJ 27OA00681200) | |
| 152WS0006X Optometrist Sports Vision (Licence: CA 34392TLG) | |
| 152WV0400X Optometrist Vision Therapy (Licence: NJ 27OA00681200) | |
| 152WV0400X Optometrist Vision Therapy (Licence: CA 34392TLG) | |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2022-01-02 |