| NPI | 1497462600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2818) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 2378) |
| 207W00000X Ophthalmology (Licence: SC 2378) | |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2024-09-17 |