| NPI | 1790451797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00707600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OM00174900) |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2021-08-19 |