| NPI | 1255568317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTG00670) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5331) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 152W00000X Optometrist (Licence: NY TUV007422) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2022-09-21 |