| NPI | 1114369444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 2826) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 1938) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2020-12-31 |