| NPI | 1023851268 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA 004290) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 11088) | 
| Enumeration Date | 2024-06-17 | 
| Last Update Date | 2025-09-19 |