| NPI | 1316201569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007862) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14737) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2013-10-11 |