| NPI | 1003128935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007594) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 56007594) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2019-04-16 |