| NPI | 1902052327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4688) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: RI ODTG00530) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2010-01-22 |