| NPI | 1639514748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5334) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007841) |
| 152W00000X Optometrist (Licence: PA 002654) | |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2023-02-25 |