| NPI | 1891707659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4684) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NH 792) |
| 152W00000X Optometrist (Licence: ME 0892) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2014-01-06 |