| NPI | 1417974114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT0002532) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1355) |
| 152W00000X Optometrist (Licence: NC 1748) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2010-03-29 |