NPI | 1295020113 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010495) |
Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 4667) |
152W00000X Optometrist (Licence: TX 9075) | |
Enumeration Date | 2011-06-20 |
Last Update Date | 2018-03-17 |