| NPI | 1699855510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002906) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2000164540) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2022-01-17 |