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 |