| NPI | 1316225006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 002830) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUVOO7724-1) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2011-07-28 |