| NPI | 1710875612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618003613) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003687) |
| Enumeration Date | 2025-06-27 |
| Last Update Date | 2026-08-17 |