Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC4899 | FL |
NPI | 1003169210 |
---|---|
Provider Name | Dr. Kathryn Mar Jip Pomakis |
First Address | Ocala, FL 34471-4452 |
Second Address | Ocala, FL 34474-4790 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2012 |
Last Update Date | 30/04/2021 |