| NPI | 1225477466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL R254TAB14) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002757) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2020-08-19 |