| NPI | 1629157078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-A92-TA-672) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC4080) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2009-09-01 |