| NPI | 1255180428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61543277) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG004188) |
| Enumeration Date | 2024-05-18 |
| Last Update Date | 2025-09-16 |