| NPI | 1972947133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR ATI3558) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MT 3968) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2025-08-07 |