| NPI | 1972852366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OFC55) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 49010047000) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2012-08-31 |