| NPI | 1023492741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003078) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003028) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2022-08-30 |