| NPI | 1912948100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 3727) |
| Additional Taxonomies | 152WL0500X Optometrist Low Vision Rehabilitation (Licence: FL 3727) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-07-16 |