| NPI | 1619653607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC6433) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009811) |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2026-02-04 |