| NPI | 1063165108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 6362) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5529) |
| Enumeration Date | 2022-01-29 |
| Last Update Date | 2025-02-26 |