| NPI | 1447690607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ AZ 2038) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002755) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2016-02-19 |