| NPI | 1962175323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTG00729) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 002523) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2023-07-11 |