| NPI | 1265107213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: FL OPC6007) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3707) |
| 152WP0200X Optometrist, Pediatrics (Licence: TN 3707) | |
| 152W00000X Optometrist (Licence: FL 6007) | |
| 152W00000X Optometrist (Licence: FL OPC6007) | |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2024-01-04 |