| NPI | 1356995294 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3285) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV009039) | 
| Enumeration Date | 2019-07-29 | 
| Last Update Date | 2024-11-07 |