| NPI | 1912374299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MT OPT-OPT-LIC-4640) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00661600) |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2025-10-28 |