| NPI | 1568607224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT001007) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA 1007T) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2022-02-16 |