| NPI | 1902017965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: NY TUV006820) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00597800) |
| 152WP0200X Optometrist, Pediatrics (Licence: NY TUV006820) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2015-08-09 |