| NPI | 1831629278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5425) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003268) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2021-03-31 |