| NPI | 1134532492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 008122) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002326) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2020-10-18 |