| NPI | 1174743553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 006259) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 002690) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2016-03-29 |