| NPI | 1710047329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT001177) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA 001177) |
| 152W00000X Optometrist (Licence: FL OPC2705) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2022-12-27 |