| NPI | 1255771440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG002791) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NV 794) |
| 152W00000X Optometrist (Licence: CA 15138) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2026-04-07 |