| NPI | 1306212873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5261) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2015029612) |
| 152WP0200X Optometrist, Pediatrics (Licence: MO 2015029612) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2022-05-05 |