| NPI | 1407623424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003689) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WV 3033-IOD) |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2025-09-26 |