| NPI | 1134606916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2705) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003115) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2022-09-07 |