| NPI | 1225873607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10959) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 011348) |
| 152W00000X Optometrist (Licence: MD TA3129) | |
| 152W00000X Optometrist (Licence: PA OET009174) | |
| 152W00000X Optometrist (Licence: IA 135166) | |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2026-02-26 |