| NPI | 1851391338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY VUT006105) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00608700) |
| 152WV0400X Optometrist Vision Therapy (Licence: NJ 27TO00146000) | |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2007-07-11 |