NPI | 1609108109 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4785) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NH 0837) |
152W00000X Optometrist (Licence: NY TUV007514-1) | |
Enumeration Date | 2010-02-08 |
Last Update Date | 2015-10-30 |