| NPI | 1194167098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002992) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3113) |
| 152W00000X Optometrist (Licence: FL OPC5036) | |
| 152W00000X Optometrist (Licence: WA 60423082) | |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2024-07-11 |