| NPI | 1184972648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007901) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA TLG14499) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |