| NPI | 1336707082 | 
|---|---|
| Former Name | LESLIE SOMOHANO | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC005989)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 1689870602)  | 
| Enumeration Date | 2019-05-29 | 
| Last Update Date | 2022-04-27 |