| NPI | 1124845953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003621) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC6646) |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2025-09-10 |