| NPI | 1548660517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2019042773) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002875) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2022-08-02 |