| NPI | 1346793205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ME OPT977) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003191) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2022-07-21 |