| NPI | 1700335718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003206) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.011070) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2024-03-07 |