| NPI | 1952697625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4614) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 002513) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2016-08-17 |