| NPI | 1689410565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0004049) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5714) |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2025-08-04 |