| NPI | 1437124070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4840) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001423) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2011-09-13 |