| NPI | 1639434442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4779) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002631) |
| Enumeration Date | 2012-07-08 |
| Last Update Date | 2013-09-04 |