| NPI | 1235623570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2972) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2018019397) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2025-05-12 |