| NPI | 1548789654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTG00655) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5231) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2020-10-09 |