| NPI | 1891025136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 2770) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 04585T) |
| 152W00000X Optometrist (Licence: VA 0618001209) | |
| 152W00000X Optometrist (Licence: PR 339) | |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2010-07-07 |