| NPI | 1083268643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 011301) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9748T) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2025-11-05 |