| NPI | 1275911950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 5869) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VT 030.0133907) |
| 152W00000X Optometrist (Licence: NJ 27OM00153300) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2023-07-31 |