| NPI | 1053482687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6909TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002303) |
| 152W00000X Optometrist (Licence: MD TA2395) | |
| 152W00000X Optometrist (Licence: FL TPOP29) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2026-03-16 |