| NPI | 1568610087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 002424) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC4292) |
| 152W00000X Optometrist (Licence: MD TA2878) | |
| 152W00000X Optometrist (Licence: SC 2291) | |
| 152W00000X Optometrist (Licence: WA OD61211822) | |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2023-04-11 |