| NPI | 1699925420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007437-1) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA t13619) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA t13619) | |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2010-05-07 |