| NPI | 1184909210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4654) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1649) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2017-08-03 |