| NPI | 1265846703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5452) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2017031245) |
| 152W00000X Optometrist (Licence: IL 046010899) | |
| 152W00000X Optometrist (Licence: OH 6326) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2018-11-05 |