| NPI | 1508264193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC005014) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5014) |
| 152WC0802X Optometrist Corneal and Contact Management (Licence: FL OPC005014) | |
| 152WP0200X Optometrist Pediatrics (Licence: FL OPC005014) | |
| 152WV0400X Optometrist Vision Therapy (Licence: FL OPC005014) | |
| Enumeration Date | 2014-12-12 |
| Last Update Date | 2021-03-02 |