| NPI | 1770770893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4266) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT13195 TPA) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-10-02 |