| NPI | 1992205785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00676600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008684) |
| Enumeration Date | 2018-02-18 |
| Last Update Date | 2018-02-18 |