| NPI | 1588608608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 2161) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002365) |
| 152W00000X Optometrist (Licence: GA 2365) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-09-08 |