| NPI | 1922199082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV004697) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC2321) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-08 |