| NPI | 1396938353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002456) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 7114T) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2022-01-07 |