| NPI | 1124109046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00605000) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007087-1) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2010-08-26 |