| NPI | 1043097272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR ATI4723) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 14221057-9934) |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2025-10-08 |