| NPI | 1558777664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 4797AT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002928) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2025-12-12 |