| NPI | 1467668129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY T005712) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: NY 8114-1) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |