| NPI | 1184604191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002279) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8123-T) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2022-07-26 |