| NPI | 1699516450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-002788) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT35934-TLG) |
| 152W00000X Optometrist (Licence: FL OPC6570) | |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2025-09-29 |