| NPI | 1366404824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC OPT1304) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002118) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2022-05-26 |