| NPI | 1659711802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN TN3157) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002763) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2021-08-25 |