| NPI | 1780791194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3175-035) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007044-1) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-07-26 |