| NPI | 1114281235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4714) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002609) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2013-06-17 |