| NPI | 1083616155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: FL OPC2787) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: FL OPC2787) |
| 152WX0102X Optometrist, Occupational Vision (Licence: FL OPC2787) | |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2011-12-14 |