NPI | 1386905537 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007805-1) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4886) |
Enumeration Date | 2012-06-05 |
Last Update Date | 2017-03-01 |