| NPI | 1700983848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007237-1) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002007) |
| 152W00000X Optometrist (Licence: NJ 27OA00162501) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2014-10-22 |