| NPI | 1942682703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ME OPT970) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5098) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2021-12-17 |