| NPI | 1083283105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2910) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2021022050) |
| 152W00000X Optometrist (Licence: MD TA3157) | |
| 152W00000X Optometrist (Licence: CT 3470) | |
| 152W00000X Optometrist (Licence: VA 0618003648) | |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2026-07-13 |