| NPI | 1962404079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY U5529) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ VUT5149/TOO210) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2011-04-21 |