| NPI | 1417976598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY T005443) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NY T005443) |
| 152WP0200X Optometrist, Pediatrics (Licence: NY T005443) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2008-04-01 |