| NPI | 1861807380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2018043160) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV008133-1) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2019-11-01 |