| NPI | 1104905264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007054) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AK 248) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2019-05-01 |