| NPI | 1912018755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC004107) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2494) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-08-08 |