| NPI | 1336422104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 02851) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV0077621) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2012-10-23 |