| NPI | 1104551746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2943) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AR 2862) |
| 152W00000X Optometrist (Licence: AR OP1100729) | |
| 152W00000X Optometrist (Licence: FL OPC6393) | |
| 152W00000X Optometrist (Licence: VA 0618003357) | |
| 152W00000X Optometrist (Licence: SC 2420) | |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2023-12-14 |