| NPI | 1912335449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4892) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002287) |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2014-10-27 |