| NPI | 1578803201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0003271) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 3271) |
| 152W00000X Optometrist (Licence: GA GA # OPT002786) | |
| 152W00000X Optometrist (Licence: FL OPC 5032) | |
| Enumeration Date | 2013-02-16 |
| Last Update Date | 2024-06-14 |