| NPI | 1124212519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV7215) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1710 DT) |
| 152W00000X Optometrist (Licence: OH 5756/T2670) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2024-08-06 |