| NPI | 1114908076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTG00579) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4426) |
| 152W00000X Optometrist (Licence: RI ODTA00514) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2019-01-29 |