| NPI | 1760762769 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4633)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6051/T2966)  | 
| Enumeration Date | 2011-08-22 | 
| Last Update Date | 2025-07-19 |