| NPI | 1750113098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 010009) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA OPT8278) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2025-05-19 |