| NPI | 1427202738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 0PC4492) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 7311T) |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2011-09-27 |