| NPI | 1679356786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC6355) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003527) |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2026-08-20 |