| NPI | 1386027662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5063) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT6422) |
| Enumeration Date | 2015-07-03 |
| Last Update Date | 2019-12-30 |