| NPI | 1700621059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618003434) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2860) |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2025-07-26 |