| NPI | 1679460240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD 3081) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 36171) |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2026-02-02 |