| NPI | 1063547180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00606100) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006901) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-07-08 |