| NPI | 1376761627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 3130) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003209) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2021-09-20 |