| NPI | 1881215465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WY 430T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 14249346) |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2025-11-06 |