| NPI | 1356587976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VT 030.0133982) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5132) |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2023-07-27 |