| NPI | 1053430553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT 11985 TPL) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 3754) |
| 152W00000X Optometrist (Licence: GA OPT002035) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2014-03-29 |