| NPI | 1568659845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTG00708) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 3049) |
| 152W00000X Optometrist (Licence: VA 0618002621) | |
| 152W00000X Optometrist (Licence: PA OEG002217) | |
| 152W00000X Optometrist (Licence: WA OD 60284399) | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2022-07-21 |