| NPI | 1609259027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9880TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: RI ODTG00621) |
| 152W00000X Optometrist (Licence: RI CODTG00621) | |
| 152W00000X Optometrist (Licence: NY TUV008451) | |
| 152W00000X Optometrist (Licence: MA 5139) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2020-03-05 |