| NPI | 1790853141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 3412) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA MA3412) |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2025-05-02 |