| NPI | 1164620217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4699) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 7058TG) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2017-04-03 |