| NPI | 1790019743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA OPT5265) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VT 030.0133978) |
| 152W00000X Optometrist (Licence: NY TUV009717) | |
| 152W00000X Optometrist (Licence: NH 1064) | |
| 152W00000X Optometrist (Licence: IL 046010203) | |
| 152W00000X Optometrist (Licence: FL TPOP90) | |
| 152W00000X Optometrist (Licence: IA 118668) | |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2024-09-13 |