| NPI | 1851546543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 2502) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1540) |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2011-08-30 |