| NPI | 1275055378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5555) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9263T) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2022-01-10 |