| NPI | 1063518801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00584200) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV 006545) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2016-05-02 |