| NPI | 1073706529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3089) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002414) |
| Enumeration Date | 2007-08-18 |
| Last Update Date | 2023-02-20 |