| NPI | 1558180067 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 6622) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 2510) | 
| Enumeration Date | 2024-10-10 | 
| Last Update Date | 2025-10-21 |