| NPI | 1902336654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003023) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3382) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2018-03-09 |