| NPI | 1588046221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTG00615) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003050) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2015-06-19 |