| NPI | 1669550034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 001760) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 006074) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-09-24 |