| NPI | 1912071812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00552600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27TO00090100) |
| 152W00000X Optometrist (Licence: NY TUV5880) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2022-05-26 |