| NPI | 1790072650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5008) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010471) |
| 152WP0200X Optometrist, Pediatrics (Licence: IL 046010471) | |
| 152W00000X Optometrist (Licence: RI ODTG00633) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2016-10-06 |