| NPI | 1629032743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTA00526) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 002440) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-09-21 |