| NPI | 1396095097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4763) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3264-35) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2020-08-12 |