| NPI | 1295329506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10177T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 4062) |
| 152W00000X Optometrist (Licence: NY 011417) | |
| 152W00000X Optometrist (Licence: PA OET009182) | |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2026-07-17 |