| NPI | 1033546304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VT 030.0109074) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4971) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2015-12-30 |