| NPI | 1477966224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003286) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.010806) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2024-06-11 |