| NPI | 1982203683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3276) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009271) |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2022-11-03 |