| NPI | 1265767107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1616) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002560) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2015-03-26 |