| NPI | 1588722508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 1120-T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S644) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-07-09 |