| NPI | 1609126341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2272) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: NC 2272) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: NC 2272) | |
| 152WX0102X Optometrist, Occupational Vision (Licence: NC 2272) | |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2025-12-15 |