| NPI | 1245582154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 005282) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27TO00089800) |
| 152W00000X Optometrist (Licence: NJ 27OA00541000) | |
| 152W00000X Optometrist (Licence: NJ 27OM00090800) | |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2012-10-03 |