| NPI | 1285935205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007650) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 270A00628600) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2016-03-14 |