| NPI | 1245894229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VT 030.0133956) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2019018360) |
| 152W00000X Optometrist (Licence: NH 1057) | |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2022-03-22 |