| NPI | 1649267055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1460) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL TPOP66) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2021-06-10 |