| NPI | 1790337939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5776) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003174) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2021-08-11 |