| NPI | 1376716860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 002738) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 006085) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-04-07 |