| NPI | 1427212497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007274) |
| Additional Taxonomies | 152WL0500X Optometrist Low Vision Rehabilitation (Licence: CA OPT 13689 TPA) |
| 152WL0500X Optometrist Low Vision Rehabilitation (Licence: AZ 1645) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2009-09-22 |