| NPI | 1962136002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 011028) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 35268) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2024-11-26 |