| NPI | 1366588683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9540) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 4055) |
| 152WL0500X Optometrist Low Vision Rehabilitation (Licence: FL OPC 4055) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-06-08 |