| NPI | 1124300413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5850) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002476) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2024-02-07 |