| NPI | 1679559108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4182) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: RI ODTA00544) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2016-03-16 |