| NPI | 1225688609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002921) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009057) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2020-09-03 |