| NPI | 1760762769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4633) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6051/T2966) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2014-05-21 |