| NPI | 1144750035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: NY 8632) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008632) |
| 152W00000X Optometrist (Licence: CT 3039) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: CT 3039) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2019-05-02 |