| NPI | 1659670982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002643) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 4533) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2015-06-29 |