| NPI | 1578637559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4368) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OT002287) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2011-08-24 |