| NPI | 1093224230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OFC82) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003346) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2018-03-19 |