| NPI | 1184774846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT1862) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1909) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2018-03-17 |