| NPI | 1720631211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTG00710) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002778) |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2021-09-29 |