| NPI | 1750055083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00707500) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009395) |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2021-08-02 |