| NPI | 1225268659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4728) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5886) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2014-01-08 |