| NPI | 1902266455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5295) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2510) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2017-02-06 |