| NPI | 1902254105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003149) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6487) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2022-06-01 |