| NPI | 1083363360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 136912) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0003876) |
| 152W00000X Optometrist (Licence: AZ OPT-002612) | |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2026-04-27 |