| NPI | 1225790462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2702) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC6020) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2026-04-06 |