| NPI | 1275549099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 002589) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4316) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2009-12-14 |