| NPI | 1659808707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3030) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002587) |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2018-03-17 |