| NPI | 1992845176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV006677) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00591600) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2023-10-12 |