| NPI | 1235399049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2715) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007159-1) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2012-09-20 |