| NPI | 1740563436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL R-181-TA-874) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 2887) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2011-09-20 |