| NPI | 1316109184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4310) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002139) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2012-01-10 |