| NPI | 1407130644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5405) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002670) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2022-07-21 |