| NPI | 1053424564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4368) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2010035330) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2012-04-20 |