| NPI | 1871837153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002699) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3278) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2015-06-29 |