| NPI | 1790631885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 2476DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18004681A) |
| Enumeration Date | 2026-03-10 |
| Last Update Date | 2026-07-29 |