| NPI | 1770256042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPFC101) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10374) |
| Enumeration Date | 2021-07-31 |
| Last Update Date | 2021-10-04 |