| NPI | 1053560706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4680) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: MA 4680) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2011-11-02 |