| NPI | 1063601128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002807) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: WY WY222T) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2014-09-27 |