| NPI | 1760839393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN OD3307) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL T224TAA39) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2019-08-12 |