| NPI | 1619753605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC6493) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2772) |
| 152WP0200X Optometrist, Pediatrics (Licence: FL OPC6493) | |
| 152WP0200X Optometrist, Pediatrics (Licence: NC 2772) | |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2024-08-08 |