| NPI | 1972125904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1562) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VT 030.0133923-EMGY) |
| 152W00000X Optometrist (Licence: VT 030.0133929) | |
| 152W00000X Optometrist (Licence: NH 1012) | |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2022-01-21 |