| NPI | 1982691812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN TN1767) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OP0002996) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2008-04-17 |