| NPI | 1477769560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 3681TX) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 4129) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2012-02-07 |