| NPI | 1982673588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4742) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2004019133) |
| 152W00000X Optometrist (Licence: NY 6346) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2012-05-22 |