| NPI | 1003129610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NH 0985) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2903) |
| 152W00000X Optometrist (Licence: RI ODTG00550) | |
| Enumeration Date | 2010-07-24 |
| Last Update Date | 2025-10-08 |