| NPI | 1023533957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV008673) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5520) |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2022-04-08 |