| NPI | 1265841100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003217) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5026) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2021-01-09 |