| NPI | 1003461666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV009750-01) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5661) |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2024-01-02 |