| NPI | 1750109021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD 3039) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618003429) |
| Enumeration Date | 2024-09-26 |
| Last Update Date | 2026-03-03 |