| NPI | 1962527846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY T006053-1) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00549600) |
| 152W00000X Optometrist (Licence: NJ 27TO00087000) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2008-05-05 |