| NPI | 1629639067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5884) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003163) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2021-04-19 |