| NPI | 1174870976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 002860) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC4764) |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2016-06-08 |