| NPI | 1275827297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5011) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002668) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2021-09-27 |