| NPI | 1598078123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1872) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2220) |
| 152W00000X Optometrist (Licence: MO 2010032151) | |
| 152W00000X Optometrist (Licence: FL OPC 4543) | |
| Enumeration Date | 2010-07-25 |
| Last Update Date | 2016-11-18 |