| NPI | 1568353084 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3431) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA OPT8315) | 
| Enumeration Date | 2025-07-12 | 
| Last Update Date | 2025-10-19 |