| NPI | 1528735693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5629) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VT 030.0133949) |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2024-09-27 |