| NPI | 1295966174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002538) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003574A) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2021-10-01 |