| NPI | 1851554430 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4793) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002087) | 
| Enumeration Date | 2008-07-03 | 
| Last Update Date | 2016-05-25 |