| NPI | 1255772851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5416) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002270) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2025-02-03 |