| NPI | 1487110656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2720) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5622) |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2021-10-14 |