| NPI | 1881762557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL fl3414) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY ky1634) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2012-08-07 |