| NPI | 1023318227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2223) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC4588) |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2014-12-16 |