| NPI | 1922857044 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA OPT5715)  | 
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: MA OPT5715)  | 
| Enumeration Date | 2024-05-13 | 
| Last Update Date | 2025-07-10 |