| NPI | 1750687562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8263T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL TPOP96) |
| 152W00000X Optometrist (Licence: CT 3244) | |
| 152W00000X Optometrist (Licence: GA OPT003491) | |
| 152W00000X Optometrist (Licence: MD TA2219) | |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2024-11-18 |