| NPI | 1962767236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1433) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010577) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2015-07-14 |