| 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 |