| NPI | 1922561315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 270A00685600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00685600) |
| 152W00000X Optometrist (Licence: NJ 27OM00153200) | |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2019-04-11 |