| NPI | 1205949864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4151) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY VUT007069) |
| 152WP0200X Optometrist, Pediatrics (Licence: NY VUT007069) | |
| 152WP0200X Optometrist, Pediatrics (Licence: FL OPC4151) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2019-04-01 |