| NPI | 1013316413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 008453) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 15104) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2019-04-18 |