| NPI | 1902910573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1005) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: AZ Opt-001005) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2025-02-28 |