| NPI | 1184057887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 2754) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA Opt2754) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2019-01-04 |