| NPI | 1962875542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV008375-1) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00664300) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2016-04-04 |