| NPI | 1407998388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 1694) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT001694) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2024-01-02 |