| NPI | 1225235575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4105) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OB 3403) |
| 152W00000X Optometrist (Licence: MA 4442) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2007-07-08 |