| NPI | 1639403058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE I3-0001346) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002557) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2014-01-31 |