| NPI | 1962012609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC6021) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009219) |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2023-01-19 |