| NPI | 1912238478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4417) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4779) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2021-10-10 |