| NPI | 1790780260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00578401) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00578400) |
| 152W00000X Optometrist (Licence: NY TUV006397-1) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2011-10-20 |