| NPI | 1760524268 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR AT4601)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007047)  | 
| 152W00000X Optometrist (Licence: CA 13422)  | |
| Enumeration Date | 2007-02-12 | 
| Last Update Date | 2023-04-20 |