| NPI | 1558746511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5560) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NH 0916) |
| 152W00000X Optometrist (Licence: VA 0618002435) | |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2019-06-04 |