| NPI | 1205524295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 003610) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 002712) |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2024-09-03 |