| NPI | 1851457030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4373-TP) |
| Additional Taxonomies | 152WL0500X Optometrist Low Vision Rehabilitation (Licence: MA 4373-TP) |
| 152WL0500X Optometrist Low Vision Rehabilitation (Licence: VT 030.0133973) | |
| 152WP0200X Optometrist Pediatrics (Licence: MA 4373-TP) | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2024-01-30 |