| NPI | 1376859611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4545) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001970) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2012-01-20 |