| NPI | 1760817431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OFC62) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OEG002812) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2013-09-12 |