| NPI | 1720141757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT001217) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 3435) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2016-01-28 |