| NPI | 1083713622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4017) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN OD2640) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-04-01 |