| NPI | 1538416698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5452) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL TPOP63) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: PA OEG002637) | |
| 152W00000X Optometrist (Licence: NJ 27OA00721400) | |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2024-01-09 |