| NPI | 1417255100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY T004731) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 4337 T909) |
| 152W00000X Optometrist (Licence: MA 3327) | |
| 152W00000X Optometrist (Licence: IL 046-008067) | |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2011-03-04 |