| NPI | 1912057555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV5361) |
| Additional Taxonomies | 156FC0800X Technician/Technologist, Contact Lens (Licence: NY TUV5361) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2011-07-06 |