| NPI | 1962526897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 3997) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3200) |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2016-08-25 |