| NPI | 1033809884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: MA OPT5618) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA OPT5618) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2024-08-12 |