| NPI | 1700999448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 152W00000X) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 152W00000X) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2007-07-08 |