| NPI | 1942282702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WV0400X Optometrist Vision Therapy (Licence: NJ 27OA00610300) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006908) |
| 152W00000X Optometrist (Licence: VT 030-0000343) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2011-01-17 |