| NPI | 1851438519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 2470) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PR 254) |
| 152W00000X Optometrist (Licence: PA OE-006859) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2022-11-10 |