| NPI | 1750366522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV0003534-1) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OC005216T) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2021-05-13 |