| NPI | 1215973912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 2436-035) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 2623) |
| 152W00000X Optometrist (Licence: MN 2312) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2007-07-16 |