| NPI | 1598010647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 007893) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3674) |
| 152W00000X Optometrist (Licence: NY TUV007893) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2024-05-20 |