| NPI | 1942378955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002052) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 2248) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |