| NPI | 1801891403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2027) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 0006064UVT) |
| 152W00000X Optometrist (Licence: DE 13-0001320) | |
| 152WP0200X Optometrist, Pediatrics (Licence: NY 0006064UVT) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2022-02-14 |