NPI | 1063165108 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL 6362) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5529) |
Enumeration Date | 2022-01-29 |
Last Update Date | 2025-02-26 |