| NPI | 1902802176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 1976) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA 1809) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2010-04-13 |