| NPI | 1083095806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5318) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 2944) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2019-12-13 |