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 |