| NPI | 1003079393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV0072751) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00615000) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-08-28 |