| NPI | 1184058174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4796) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 4796) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2019-03-25 |