| NPI | 1033146964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4401) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA oeg001680) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA OPT13803TPL) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2014-12-03 |