| NPI | 1083138192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3048) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 8671) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2017-07-31 |