| NPI | 1003243502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC6053) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901004806) |
| 152W00000X Optometrist (Licence: GA OPT002962) | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2022-07-19 |