| NPI | 1134969546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003675) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG004196) |
| 152W00000X Optometrist (Licence: FL OPC6468) | |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2025-09-18 |