| NPI | 1750732673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5457) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: FL OPC5457) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2020-06-06 |