| NPI | 1336104330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002328) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV0069051) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2011-02-08 |