| NPI | 1649401225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN OD2900) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002542) |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2010-08-23 |