| NPI | 1770904427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002797) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002880) |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2014-04-27 |