| NPI | 1962651364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3211-35) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ME OPT904) |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2014-01-22 |