| NPI | 1811370331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002946) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 5175) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2018-06-27 |