| NPI | 1427610302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003283) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5679) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2020-11-18 |