| NPI | 1922391903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002713) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL T-205-TA-884) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2012-09-12 |