| NPI | 1306220785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 56008349) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00660600) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2016-01-22 |