| NPI | 1023201555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 2395) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1547 576T) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2021-04-15 |