| NPI | 1063895027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND 752) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3242) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2025-09-24 |