| NPI | 1205455847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ME OPT1047) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002884) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2023-10-12 |