| NPI | 1518096460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL opc4254) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: DC OP764) |
| 152W00000X Optometrist (Licence: VA 0618001274) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2010-03-03 |