| NPI | 1578792891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: NY TUV007455) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 13772) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2011-09-02 |