| NPI | 1215389507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33487) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5198) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2017-02-15 |