Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 5435 | MA |
NPI | 1013535772 |
---|---|
Provider Name | Clarissa Ngui |
First Address | Boston, MA 02215-3909 |
Second Address | Boston, MA 02215-3909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2020 |
Last Update Date | 14/11/2020 |