| NPI | 1639401169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4794) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 2786) |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2024-03-08 |