| NPI | 1073593059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4285) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618000921) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2012-03-14 |