| NPI | 1033399795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007439) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002310) |
| Enumeration Date | 2007-11-11 |
| Last Update Date | 2010-02-02 |