| NPI | 1760040760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2669) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5672) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2021-11-04 |