| NPI | 1508065020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1750DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007185) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2011-10-24 |