| NPI | 1992315485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 009231) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 1992315485) |
| Enumeration Date | 2020-08-09 |
| Last Update Date | 2026-07-01 |