| NPI | 1134450752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4777) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NH 1081) |
| 152W00000X Optometrist (Licence: FL OPC5146) | |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2024-01-09 |