| NPI | 1124162888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 3573) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 12101T) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2008-02-12 |