| NPI | 1861858128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002555) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2291) |
| Enumeration Date | 2016-01-01 |
| Last Update Date | 2016-01-01 |