NPI | 1356844104 |
---|---|
Former Name | CLAUDIA CAMILA DIAZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5487) |
Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: FL OPC5487) |
Enumeration Date | 2018-03-16 |
Last Update Date | 2021-11-16 |