| NPI | 1164469490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 3409) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618000810) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-12-03 |