| NPI | 1649055690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 011069) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: RI ODTG00742) |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2025-02-03 |