| NPI | 1457791675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 0003358) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008050) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2018-07-26 |