| NPI | 1588433312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC6377) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT007233) |
| Enumeration Date | 2023-12-20 |
| Last Update Date | 2023-12-20 |