| NPI | 1194130203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 4941) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL OPC4941) |
| 152W00000X Optometrist (Licence: FL OPC4941) | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2018-08-23 |