| NPI | 1982734166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OFC03-01) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 2007ATI) |
| 152W00000X Optometrist (Licence: WA 1728) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |