| NPI | 1124361050 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: FL OPC4761) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC4761) | 
| 152W00000X Optometrist (Licence: TX 8010T) | |
| 152WP0200X Optometrist, Pediatrics (Licence: FL OPC4761) | |
| 152WX0102X Optometrist, Occupational Vision (Licence: FL OPC4761) | |
| Enumeration Date | 2013-03-28 | 
| Last Update Date | 2023-04-26 |