| NPI | 1336782259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3132) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NH 1006) |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2020-03-29 |