| NPI | 1548990534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: MA OPT5566) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5566) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2023-07-14 |