| NPI | 1801100870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4849) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 002813) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2013-07-10 |