| 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 |