| NPI | 1689928293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: NY 55 009252) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY VUT5575) |
| Enumeration Date | 2012-11-04 |
| Last Update Date | 2012-11-04 |