| NPI | 1760969133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3096) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY t008848) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2019-06-03 |