| NPI | 1164420790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ME 877) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4853) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2022-12-21 |