| NPI | 1710126883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4324) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001796) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2010-03-02 |