| NPI | 1508802513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27TO00116402) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY T006396) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2007-11-14 |