| NPI | 1679127872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: HI OD-1043) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003595) |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2024-10-07 |