| NPI | 1568353084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3431) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA OPT8315) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-07-12 |
| Last Update Date | 2025-10-02 |