| NPI | 1134117633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2079) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV-6853) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2021-10-04 |