| NPI | 1902071970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4288) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002436) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2011-08-15 |