| NPI | 1235689613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002857) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002981) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2020-03-08 |