| NPI | 1225260706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV004486-1) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00434200) |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2009-08-17 |