| NPI | 1376299040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WY 447T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 12793207-9934) |
| 152W00000X Optometrist (Licence: MT 4280) | |
| 152W00000X Optometrist (Licence: PA OEG004119) | |
| 152W00000X Optometrist (Licence: VA 0618003187) | |
| 152W00000X Optometrist (Licence: ID ODP-100599) | |
| 152W00000X Optometrist (Licence: WA OD61409137) | |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2025-07-21 |