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 |