| NPI | 1245208412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 004399-1) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 4399) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-06-30 |