| NPI | 1750355467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4212) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MA 4212) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2015-08-25 |