| NPI | 1871802942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL FLOPC2424) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA OP 3547) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2010-10-06 |