| NPI | 1780318436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV009553) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009553) |
| 152WV0400X Optometrist Vision Therapy (Licence: NY 009553) | |
| Enumeration Date | 2022-07-10 |
| Last Update Date | 2022-07-14 |