| NPI | 1457863870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002826) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5470) |
| 152W00000X Optometrist (Licence: PA OEG004120) | |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2024-10-30 |