| NPI | 1104931724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002237) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2258DT) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: GA OPT002237) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2024-02-23 |