| NPI | 1417466863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5907) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OFC85) |
| 152W00000X Optometrist (Licence: PA OEG003355) | |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2021-10-12 |