| NPI | 1407316102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5336) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008854) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2023-03-01 |