| NPI | 1508869009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OFC27) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 5667T) |
| 152W00000X Optometrist (Licence: VA 0601001408) | |
| 152W00000X Optometrist (Licence: TN 2850) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2023-03-07 |