| NPI | 1407697907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618003557) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.007288) |
| 152W00000X Optometrist (Licence: WV 3042-IOD) | |
| Enumeration Date | 2024-06-06 |
| Last Update Date | 2025-08-22 |