| NPI | 1902035595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00629600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV 007408) |
| Enumeration Date | 2009-07-05 |
| Last Update Date | 2016-10-18 |