| NPI | 1629555131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003127) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5582) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2023-05-04 |