| NPI | 1962884684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC6166) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1889) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2026-01-26 |