| NPI | 1144889585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002750) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2798) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2025-09-13 |