| NPI | 1376741538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002393) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 2763) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2011-06-13 |