| NPI | 1538413232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OFC59) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002707) |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2012-11-01 |