| NPI | 1053580142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 007242) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PR 655) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2023-02-16 |