| NPI | 1013331750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002842) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV008095) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2018-04-30 |