| NPI | 1922077916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VT VT0300000300) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 618000255) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2021-10-15 |