| NPI | 1750526091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007380-1) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4704) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2009-05-04 |