| NPI | 1053896001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTG00668) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: RI CODTG00668) |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2018-09-26 |