| NPI | 1538599014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5004) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: RI ODTG00603) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2023-01-05 |