| NPI | 1124282041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4420) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007304) |
| 152W00000X Optometrist (Licence: PA OEG002550) | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2024-01-23 |