| NPI | 1891304465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA OPT5582) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY Tuv009191) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2023-08-16 |