| NPI | 1962855437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 2032DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 5190) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2018-07-30 |