| NPI | 1205210184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA OPT5684) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003057) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: MD TA2526) | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2025-01-13 |