| NPI | 1174839146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4926) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 002810) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2023-11-27 |