| NPI | 1255384152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00603000) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007016-1) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-04-04 |