| NPI | 1548424823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001693) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007238) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2011-05-03 |