| NPI | 1811089055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 3964) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 11001T) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2012-11-19 |