| NPI | 1366882458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4916) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002813) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2014-08-19 |