| NPI | 1285017988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTG00614) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI ODTG00614) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-09-15 |