| NPI | 1477928505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003289) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL 2096) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2020-12-23 |