| NPI | 1538534474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 002481) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 5291) |
| 152W00000X Optometrist (Licence: GA OPT002896) | |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2021-09-28 |