| NPI | 1790209666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5352) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 2021-967AT) |
| 152W00000X Optometrist (Licence: PA OEG004006) | |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2024-02-13 |