| NPI | 1669968509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA3138) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 2072-T) |
| 152W00000X Optometrist (Licence: PA OEG003412) | |
| 152W00000X Optometrist (Licence: VA 0618003109) | |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2026-06-09 |