| NPI | 1235284761 |
|---|---|
| Former Name | TIFFANY ANNE MATHAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10138T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC3721) |
| 152W00000X Optometrist (Licence: PA OET008883) | |
| 152WC0802X Optometrist Corneal and Contact Management (Licence: PA OET008883) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2024-04-13 |