| NPI | 1356307193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC3853) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006221) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2013-10-30 |