| NPI | 1417235318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 085121) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007814) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2022-02-23 |