| NPI | 1902886948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY UVT005332) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NY UVT005332) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2020-04-17 |