| NPI | 1114064326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 2925) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 2541) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |