| NPI | 1649688847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OFC65) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002991) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2018-02-20 |