| NPI | 1568080828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC6227) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2190DT) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2026-03-06 |