| NPI | 1386805190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 4554) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003517A) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2010-10-28 |