| NPI | 1346573987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004516) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OFC40) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2011-08-15 |