| NPI | 1346925757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NM OPT-2024-0001) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0003926) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2024-05-30 |