| NPI | 1497896435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007207) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: CA 13036T) |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2011-05-15 |