| NPI | 1043733033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: LA 1858-792AT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003010) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2023-02-17 |