| NPI | 1861984031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5374) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002649) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: VA 0618002649) | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2021-12-06 |