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 | 2024-08-08 |