| NPI | 1609215557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4840) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8258-T) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2018-09-22 |