| NPI | 1659670495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4784) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2216) |
| 152W00000X Optometrist (Licence: VA 0618002074) | |
| 152W00000X Optometrist (Licence: NJ 27OA00636600) | |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2021-09-17 |