| NPI | 1982821039 |
|---|---|
| Former Name | TARA KAY FORECKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC3860) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT11636T) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-07-08 |