| NPI | 1760081517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 107) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618003074) |
| 152W00000X Optometrist (Licence: IL 046.011775) | |
| 152W00000X Optometrist (Licence: KY 2256DT) | |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2025-07-28 |