| NPI | 1457391831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2958) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006240) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2014-02-11 |