| NPI | 1811372279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 5106) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003616) |
| 152W00000X Optometrist (Licence: NY TUV008731) | |
| 152W00000X Optometrist (Licence: WI 3650-35) | |
| 152W00000X Optometrist (Licence: MO 2020009170) | |
| 152W00000X Optometrist (Licence: MD TA2711) | |
| 152W00000X Optometrist (Licence: VT 030.0133919) | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2021-12-01 |