| NPI | 1710275995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 2835) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4949) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2013-01-09 |