| NPI | 1093991903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2772) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3250ATI) |
| 152W00000X Optometrist (Licence: FL OPC 4602) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2016-02-23 |