| NPI | 1861772980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002673) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 004619) |
| 152W00000X Optometrist (Licence: SC 1668) | |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2012-08-13 |