| NPI | 1720460918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 008306) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8823T) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2016-07-26 |