| NPI | 1669929204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5271) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 8398) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2018-09-18 |