NPI | 1992290191 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5714) |
Additional Taxonomies | 152W00000X Optometrist (Licence: UT 10842205-9934) |
Enumeration Date | 2018-06-29 |
Last Update Date | 2021-11-16 |