| NPI | 1710573118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5450) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009201) |
| Enumeration Date | 2020-12-19 |
| Last Update Date | 2021-07-23 |