| NPI | 1780364257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL R-345-TA-D54) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG004048) |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2025-07-25 |